Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies
Aim: Ipsilateral ureteroureterostomy is an established method for the treatment of duplication anomalies in children. With the advent of pediatric laparoscopy, many urologic procedures in children are being performed using minimal access techniques. We present our experience with laparoscopic ipsila...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-01-01
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| Series: | Journal of Indian Association of Pediatric Surgeons |
| Subjects: | |
| Online Access: | http://www.jiaps.com/article.asp?issn=0971-9261;year=2015;volume=20;issue=1;spage=27;epage=31;aulast=Chandrasekharam |
| _version_ | 1817993804619186176 |
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| author | VVS Chandrasekharam Harish Jayaram |
| author_facet | VVS Chandrasekharam Harish Jayaram |
| author_sort | VVS Chandrasekharam |
| collection | DOAJ |
| description | Aim: Ipsilateral ureteroureterostomy is an established method for the treatment of duplication anomalies in children. With the advent of pediatric laparoscopy, many urologic procedures in children are being performed using minimal access techniques. We present our experience with laparoscopic ipsilateral ureteroureterostomy (LIUU) for duplex anomalies. Patients and Methods: The data of children who underwent LIUU was reviewed for demographic parameters, clinical and operative details, follow-up and results. Results: Over 3 years period, LIUU was performed in eight children (age 6-60 months). Five children had complete ipsilateral duplication with ectopic upper moiety ureter, one child each had ipsilateral incomplete duplication and bilateral duplex systems (with ipsilateral ectopic upper moiety ureter). One child had ipsilateral complete duplex with Grade V vesicoureteric reflux into the lower moiety ureter. Four children had antenatal diagnosis of hydronephrosis; three children had a urinary infection and two children presented with urinary incontinence. The surgical procedure consisted of cystoscopy, retrograde studies and cannulation of the recipient ureter. Then, LIUU was performed using three ports. The ectopic (donor) ureter was divided at the pelvic brim; the recipient ureter was opened and end-to-side LIUU was performed with 5/0 vicryl stitches over a double J (DJ) stent placed in the recipient ureter. Bladder catheter was removed after 2 days, and DJ stent was removed after 4 weeks. At a mean follow-up of 19 months (3-36), all children are asymptomatic and continent, with a significant reduction in hydroureteronephrosis on ultrasound. The cosmetic results were excellent. Conclusion: LIUU is a safe and effective technique in the management of duplication anomalies in children. It could be performed with minimal blood loss, minimal postoperative pain, excellent cosmesis and good success. |
| first_indexed | 2024-04-14T01:44:39Z |
| format | Article |
| id | doaj.art-07e0ce346a324a74bfc221e9049f5090 |
| institution | Directory Open Access Journal |
| issn | 0971-9261 1998-3891 |
| language | English |
| last_indexed | 2024-04-14T01:44:39Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Indian Association of Pediatric Surgeons |
| spelling | doaj.art-07e0ce346a324a74bfc221e9049f50902022-12-22T02:19:35ZengWolters Kluwer Medknow PublicationsJournal of Indian Association of Pediatric Surgeons0971-92611998-38912015-01-01201273110.4103/0971-9261.145442Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomaliesVVS ChandrasekharamHarish JayaramAim: Ipsilateral ureteroureterostomy is an established method for the treatment of duplication anomalies in children. With the advent of pediatric laparoscopy, many urologic procedures in children are being performed using minimal access techniques. We present our experience with laparoscopic ipsilateral ureteroureterostomy (LIUU) for duplex anomalies. Patients and Methods: The data of children who underwent LIUU was reviewed for demographic parameters, clinical and operative details, follow-up and results. Results: Over 3 years period, LIUU was performed in eight children (age 6-60 months). Five children had complete ipsilateral duplication with ectopic upper moiety ureter, one child each had ipsilateral incomplete duplication and bilateral duplex systems (with ipsilateral ectopic upper moiety ureter). One child had ipsilateral complete duplex with Grade V vesicoureteric reflux into the lower moiety ureter. Four children had antenatal diagnosis of hydronephrosis; three children had a urinary infection and two children presented with urinary incontinence. The surgical procedure consisted of cystoscopy, retrograde studies and cannulation of the recipient ureter. Then, LIUU was performed using three ports. The ectopic (donor) ureter was divided at the pelvic brim; the recipient ureter was opened and end-to-side LIUU was performed with 5/0 vicryl stitches over a double J (DJ) stent placed in the recipient ureter. Bladder catheter was removed after 2 days, and DJ stent was removed after 4 weeks. At a mean follow-up of 19 months (3-36), all children are asymptomatic and continent, with a significant reduction in hydroureteronephrosis on ultrasound. The cosmetic results were excellent. Conclusion: LIUU is a safe and effective technique in the management of duplication anomalies in children. It could be performed with minimal blood loss, minimal postoperative pain, excellent cosmesis and good success.http://www.jiaps.com/article.asp?issn=0971-9261;year=2015;volume=20;issue=1;spage=27;epage=31;aulast=ChandrasekharamChildduplexlaparoscopyureteroureterostomy |
| spellingShingle | VVS Chandrasekharam Harish Jayaram Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies Journal of Indian Association of Pediatric Surgeons Child duplex laparoscopy ureteroureterostomy |
| title | Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies |
| title_full | Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies |
| title_fullStr | Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies |
| title_full_unstemmed | Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies |
| title_short | Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies |
| title_sort | laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies |
| topic | Child duplex laparoscopy ureteroureterostomy |
| url | http://www.jiaps.com/article.asp?issn=0971-9261;year=2015;volume=20;issue=1;spage=27;epage=31;aulast=Chandrasekharam |
| work_keys_str_mv | AT vvschandrasekharam laparoscopicipsilateralureteroureterostomyforthemanagementofchildrenwithduplicationanomalies AT harishjayaram laparoscopicipsilateralureteroureterostomyforthemanagementofchildrenwithduplicationanomalies |